Separation of hip joint liner and socket elements

ABSTRACT

The method of removing a hip socket liner from surface attachment to a socket, that includes providing a carrier and multiple penetrators carried to be displaced relative to the carrier, inserting the carrier in the liner so that the penetrators project toward a liner cup-shaped surface, effecting controlling limited forceful displacement of tips defined by the penetrators toward and into said liner cup-shaped surface, and transmitting pushing force acting between the carrier and hip socket whereby the liner is suddenly freed from attachment to the socket.

BACKGROUND OF THE INVENTION

This invention relates generally to hip joints and freeing of attachment elements thereof, and more particularly concerns freeing of hip joint liners from sockets to which they have become attached, over time.

There is need for a safe, easily and quickly performed method of freeing a hip joint liner from a socket to which it has become attached. This is particularly needed where metallic surfaces of the liner and socket have become attached, as for example after extensive rubbing or frictional contact. There is particular need for the method and apparatus as defined herein.

SUMMARY OF THE INVENTION

It is a major object of the invention to provide improved method and apparatus meeting the above needs. Basically, the method of the invention for removing a hip socket liner from surface attachments to a socket, includes:

a) providing a carrier and multiple penetrators carried to be displaced relative to the carrier,

b) applying the carrier to the liner so that the penetrators project toward a liner cup-shaped inner surface,

c) effecting controlled and limited forceful displacement of the penetrators so that tips defined by the penetrators penetrate said liner cup-shaped surface,

d) and transmitting jarring force to one of the liner and carrier whereby the liner is suddenly freed from said attachment to the socket. The freed liner is then withdrawn relative to the socket.

The cup-shaped interior surface is metallic, and outer surface attachment is spaced from said cup-shaped surface. At least three tips are typically employed (to penetrate directionally substantially normal to the cup-shaped liner surface.

A further object is to provide means to pull the carrier away from the liner to drag the liner, via the tips, free of engagement with the socket.

A further object is to provide axial force, and/or prying force, and/or vibration to assist liner extraction.

These and other objects and advantages of the invention, as well as the details of an illustrative embodiment, will be more fully understood from the following specification and drawings, in which:

DRAWING DESCRIPTION

FIG. 1 is a section taken through a cup-shaped acetabulum having a liner to be detached from the cup socket, and a carrier for penetration, received in the cup;

FIG. 2 is a view like FIG. 1, showing forcible displacement of the penetrators to push the tips into the liner inner surface;

FIG. 3 is a view like FIG. 2, but showing axial forcible detachment of the liner by axial displacement of the carrier and tips, directionally away from the acetabulum socket; and

FIG. 4 is a section showing position of penetrator tip penetration into the liner.

FIG. 5 is a view like FIG. 3, but showing provision and use of means to push the liner free of the socket;

FIG. 6 is a plan view of a bracket useful in such pushing;

FIG. 7 is a view taken on lines 7-7 of FIG. 6; and

FIG. 8 is an edge view of under-cut structure facilitating prying and pushing apart of the liner and socket.

DETAILED DESCRIPTION

In FIG. 1, a generally hemispherical acetabulum 10 has an inner cup-shaped surface 10 a. A liner 11 fits in the acetabulum, and has an outer convex ball shaped surface 11a that becomes attached, over time, to the surface 10 a. During hip replacement surgery, it becomes necessary to remove liner 11, which is difficult and prevents many problems.

In accordance with the invention, a carrier 13 is provided and sized to be axially received or inserted closely within the space surrounded by the liner interior cup-shaped surface 11 b. The common axis shown at 14. Multiple penetrators 15 (at least three, but up to six) are carried by 13, within generally radial through openings 16 in the carrier. Those penetrators have shafts 15 a movable endwise in the openings 16, and shaped tips 15 b which are sharp, and presented toward the liner interior surface 11 b, at spaced locations about axis 14. Those locations are preferably equally spaced about axis 14. At that time, the carrier may endwise engage the liner, as at axial location 17.

Means is provided for effecting controlled limited forceful outward displacement of the penetrators, so that their sharp tips are displaced toward and into the material of the liner cup-shaped surface lib. The tips are typically metallic, and harder than the liner material, which may also be metallic, to enable limited tip penetration into the liner. This condition is show in FIG. 2 and also FIG. 4. Such displacement is typically effected by penetrator shaft end engagement with the outer tapered surface 26 a of a cam 26, that surface being threaded conical, as shown. The cam is carried by a trapped shaft 43 to be rotated as indicated by arrow 30. The shaft threading 43 a may engage the bore threads at 31 of a carrier wall 32. That wall may also engage the rim 33 of the acetabulum part, as shown at 32 a, to position the cam.

As the penetrators are forced outward, they penetrate the liner as at grip locations 34, see in FIG. 4, which are located at equal spacing 35 a about axis 14. Typically penetration is between 1/64 and ⅛ inch.

Thereafter, the carrier is forcibly pulled or displaced to the left, as in FIG. 3, which effects simultaneous leftward bodily displacement of the penetrators, their tapered tips, and the liner 11 gripped by the tips. Subsequently the shaft 43 is rotated in the opposite direction, to allow inward bodily displacement of the penetrators and tips, freeing the liner from the carrier. The acetabulum may be held in position, as by a holder 60, during such extraction of the liner. The penetrator tips are tapered so as to release from the liner as the cam 26 is displaced by shaft 43 rotation, as referred to. If desired, the assembly can be vibrated, as by tuning fork high frequency vibrator means so to assist jarring loose of the liner.

FIG. 1 also shows a puller hook 70 attached to the shaft 43, to be pulled to assist forcible extraction of the liner from the acetabulum. Alternatively, a prying tool or blade 71 may be inserted into a notch 72 between the acetabulum and carrier, and twisted, to assist liner extraction.

Referring to FIG. 5, it shows provision of means for transmitting pushing force acting between the carrier 13 and the hip socket 10 whereby the liner 11 is suddenly and/or forcibly freed from attachment to the socket. As shown, a pusher 80, when rotated pushes the carrier to the left, in the direction of arrow 81, whereby the pusher has operative connection to the carrier. Such a connection is shown in the form of a threaded connection 82, typically made up after the carrier has been connected to the liner by rotation of screw 43 to effect carrier displacement of the penetrators 15 into the liner, at the tips of the penetrators.

A nut 84 has external thread 85 that is made up into internal thread 86 on the carrier annular part 87, to make up connector 82. This causes the pusher nut to initially move to the right until it is stopped by engagement with the end 88 a of spacer 88 engaging the socket, as at 89. Alternatively a bracket 90 may be assembled against the socket end 89, in position to block rightward travel of the nut. Continued rotation of the nut then causes the internal thread 86 on the carrier, and the carrier itself, to move bodily leftwardly, pushing the liner free of the socket, or free of an insert liner 92 carried by the socket, as in the case of a metal-to-metal ball joint where the liners 92 and 11 are “frozen” together.

Note that the nut 84 may have an end opening at 84 a, providing access to the turning knob 70 a on the stem carrying the cam 26.

It will therefore be seen that the invention provides means for readily removing a liner “frozen” in position in a socket, obviating need for the surgeon to repeatedly hammer a tool against the liner in an attempt to free it. Such hammer impacts can cause severe damage to the socket structure, and the present invention precludes risk of such potential damage.

FIG. 6 shows bracket 90 having turned ends or fittings 91 at opposite sides of axis 93 to fit against the socket ends, when the bracket interior annulus 90 is assembled over the carrier part 87. The bracket then transmits pressure from nut wall 92 to the socket end 89.

FIG. 8 shows provision of multiple (typically six) under cut openings 96 formed in the periphery of part 88, or in the bracket loop 99, adjacent end 89, to enable insert of the tip 100 a of a pry tool or bar 100. Pivoting of bar 100 then enables tip 100 a to pry or push the structure 88, 80 and liner free of the socket. A vibrating tuning fork may be used in place of bar 100.

Multiple under cuts enable selective and successive insertion of tip 100 a in two or more under cuts, and prying at such multiple locations, to ensure liner release. 

1. The method of removing a hip liner from surface attachment to a cup shaped shell, that includes: a) providing a carrier and multiple indentors or penetrators carried to be displaced relative to the carrier, b) inserting the carrier in the liner so that the indentors or penetrators project toward a liner cup-shaped surface, c) effecting controlling limited forceful displacement of tips defined by the indentors or penetrators toward and into said liner cup-shaped surface, d) and transmitting pushing force acting between the carrier and hip shell whereby the liner is suddenly freed from attachment to the shell.
 2. The method of claim 1 including providing and operating a pusher to transmit said force.
 3. The method of claim 2 wherein said pusher is provided in the form of a bracket engaging spaced portions of the shell to transmit force between the carrier and shell.
 4. The method of claim 3 wherein the bracket is provided to have opposite end fittings configured to engage external surface portions of the shell.
 5. The method of claim 3 wherein the pusher is provided to include a rotatably manipulable nut which is rotated to pull the carrier and liner axially and longitudinally away from the shell.
 6. An apparatus for removing a hip liner from a hip shell to which the liner is attached, comprising a) a carrier received into a cup-shaped recess defined by the liner, b) multiple and relatively movable indentors carried by the carrier, and means for displacing the indentors endwise so that endwise extending sharp tips thereof indent and penetrate into the cup-shaped surface defined by the liner, the indentors having force transmitting diverging elongated shafts and shaft ends remote from said tips, each said tips being in endwise linear alignment with main extent of the elongated shaft, there being a cam engaging said shaft ends to transmit push-in force endwise to said shaft ends, for effecting said penetration in the diverging directions of said shafts, the carrier defining through openings passing said shafts, c) and other means for pulling the carrier relatively axially longitudinally away from the shell whereby the carrier, indentors and liner are displaced axially away from the shell, said shafts divergently angled to transmit pulling force from said carrier to said liner via said tips, the carrier at said through openings sidewardly engaging the shafts at locations therealong in spaced relation to said tips and spaced from shaft ends engaged by the cam to transmit pulling force exertion to the indentor shafts, free of the cam, d) said shaft ends separately facing the cam for separately engaging the cam and being endwise movable during push in force exertion by the cam, and said shafts movable relative to the cam during pull out force exertion by the carrier, e) said other means including bracket configured to engage spaced portions of the shell to transmit force between the carrier and shell, the bracket having opposite end fittings configured to engage external surface portions of the shell, f) and wherein said other means includes a rotatably adjustable nut axially aligned with said cam and manipulable to displace the carrier and liner axially and longitudinally.
 7. (canceled)
 8. (canceled)
 9. (canceled)
 10. The apparatus of claim 9 wherein the nut is located mid-way between said opposite end fittings.
 11. The method of claim 5 wherein the nut defines an axis of rotation, the bracket having opposite end fittings engagable with a surface defined by the shell, said fittings disposed at opposite sides of said axis.
 12. The method of claim 11 wherein said indentors are disposed about said axis.
 13. The method of claim 1 wherein said shell comprises a hip acetabulum.
 14. The apparatus of claim 8 wherein the nut defines an axis of rotation, said bracket opposite end fittings engageable with a surface defined by the shell, said fittings disposed at opposite sides of said axis of rotation.
 15. The apparatus of claim 14 wherein said indentors are disposed about and diverge away from said axis of rotation.
 16. The apparatus of claim 6 wherein said shell comprises a hip acetabulum, and said liner consists of one of the following: a) metal b) polyethylene c) ceramic material.
 17. The apparatus of claim 6 including cutout openings in the periphery of the carrier to enable reception of a tip of a pry bar operable to pry loose the liner.
 18. The method of claim 2 wherein the pusher has circumferentially spaced local grooves or cutouts configured to receive the end of a prying tool operable to exert prying force between the carrier and said shell.
 19. The method of claim 18 including forming at least three said grooves.
 20. The apparatus of claim 9 including an extractor configured to peripherally engage said shell, the extractor carrying said rotatable nut which threadably engages the carrier so that when the nut is rotated, the carrier is displaced by force exerted by the nut.
 21. The method of removing a hip shell liner from surface attachment to a shell, that includes: a) providing a carrier and multiple indentors carried to be displaced relative to the carrier, the indentors provided to define shafts, and the carrier having through openings passing said shafts, the indentors provided to have shafts tips each of which extends endwise in the direction of main extents of its associated shaft, b) inserting the carrier in the liner so that the indentors project toward a liner cup-shaped surface, c) providing a cam movable axially within the carrier to displace the shafts endwise at diverging and acute angularity relative to said axis for effecting controlling limited forceful displacement of tips defined by the indentors toward and into said liner cup-shaped surface, d) and transmitting jarring force to one of the liner and carrier whereby the liner is suddenly freed from said attachment to the shell, e) the carrier at said through openings sidewardly engaging the shafts at locations therealong in spaced relation to said tips and spaced from shaft ends engaged by the cam to transmit pulling force exertion to the indentor shafts, free of the cam, f) locating the shaft ends to separately face the cam for separately engaging the cam and being endwise movable at said acute angularity during push in force exertion by the cam, and said shafts movable relative to the cam during pull out force exertion by the carrier.
 22. The method of claim 21 whereby said cup-shaped surface consists of metal, polyethylene or ceramic material, and said surface attachment is spaced from said cup-shaped surface.
 23. The method of claim 22 wherein said metallic surface is convex toward said shell.
 24. the method of claim 21 wherein said limited displacement effects indentation to less than ⅛ inch.
 25. The method of claim 21 wherein said tips are sharp.
 26. The method of claim 21 wherein there are at least three of said penetrator tips spaced about an axis defined by the liner.
 27. The method of claim 21 wherein said tips extend substantially normal to said cup-shaped liner surface.
 28. The method of claim 21 including inserting said carrier into said cup-shaped liner so that said tips extend substantially normal to said cup-shaped liner surface.
 29. The method of claim 21 wherein, after said step c) the carrier is pulled away from the liner to drag said liner free of engagement with the acetabular cup.
 30. The method of claim 21 including locally and peripherally prying the liner away from the shell.
 31. The method of claim 21 including providing a vibrating element engaging said one of the liner and carrier, for transmitting said jarring force.
 32. The method of claim 31 wherein said element is a tuning fork.
 33. The method of claim 21 wherein said attachment is a metal-to-metal attachment.
 34. The method of claim 21 wherein said cup-shaped surface is provided to consist essentially of one of the following: i) polyethylene ii) ceramic material iii) metallic material. 